Biomaterial Database

Progressive spontaneous herniation of the thoracic spinal cord: case report. 2000

C Ewald, and D Kühne, and W E Hassler

Neurochirurgische Klinik, Klinikum Duisburg, Germany.

OBJECTIVE We report one case of spontaneous thoracic spinal cord herniation. To our knowledge, this is the first case involving radiological documentation of the development of herniation. Clinical features and surgical techniques are also presented. METHODS We describe the case of a 51-year-old female patient who experienced progressive Brown-Sequard syndrome for 2 years. Three magnetic resonance imaging examinations were performed; they revealed the progressive development of anterolateral spinal cord herniation at the level of T6 during those 2 years. METHODS After laminectomy at T6, the herniated myelon was microsurgically removed and the neurological symptoms improved. CONCLUSIONS We present the possible causes, the proposed pathophysiological mechanisms, and the clinical and radiological development of this rare entity, with a review of the literature published to date. We propose that a preexisting weakness of the ventral dural fibers, combined with abnormal adhesion of the spinal cord to the anterior dural sleeve, leads to progressive herniation throughout life. Microsurgical treatment may halt the exacerbation of the neurological symptoms.

UI	MeSH Term	Description	Entries
D007796	Laminectomy	A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots.	Laminotomy,Laminectomies,Laminotomies
D008279	Magnetic Resonance Imaging	Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.	Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D005260	Female		Females
D006547	Hernia	Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the ABDOMINAL WALL or the respiratory DIAPHRAGM. Hernias may be internal, external, congenital, or acquired.	Enterocele,Hernias
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013118	Spinal Cord Diseases	Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord.	Myelopathy,Spinal Cord Disorders,Myelopathies,Spinal Cord Disease,Spinal Cord Disorder
D013904	Thoracic Vertebrae	A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region.	Vertebrae, Thoracic
D059685	Herniorrhaphy	Surgical procedures undertaken to repair abnormal openings through which tissue or parts of organs can protrude or are already protruding.	Hernia Repair,Hernioplasty,Hernia Repairs,Hernioplasties,Herniorrhaphies,Repair, Hernia,Repairs, Hernia
D018437	Brown-Sequard Syndrome	A syndrome associated with injury to the lateral half of the spinal cord. The condition is characterized by the following clinical features (which are found below the level of the lesion): contralateral hemisensory anesthesia to pain and temperature, ipsilateral loss of propioception, and ipsilateral motor paralysis. Tactile sensation is generally spared. (From Adams et al., Principles of Neurology, 6th ed, p162).	Hemispinal Cord Syndrome,Spastic Spinal Monoplegia Syndrome,Brown-Sequard Disease,Brown-Sequard's Disease,Brown-Sequard's Paralysis,Brown-Sequard's Syndrome,Hemicord Syndrome,Hemiparaplegic Syndrome,Brown Sequard Disease,Brown Sequard Syndrome,Brown Sequard's Disease,Brown Sequard's Paralysis,Brown Sequard's Syndrome,Brown-Sequard Paralysis,Brown-Sequards Disease,Brown-Sequards Paralysis,Brown-Sequards Syndrome,Hemicord Syndromes,Hemiparaplegic Syndromes,Hemispinal Cord Syndromes,Paralysis, Brown-Sequard's,Syndrome, Brown-Sequard,Syndrome, Brown-Sequard's,Syndrome, Hemicord,Syndrome, Hemiparaplegic,Syndrome, Hemispinal Cord,Syndromes, Hemicord,Syndromes, Hemiparaplegic,Syndromes, Hemispinal Cord